The potential of ketamine for posttraumatic stress disorder: a review of clinical evidence.

Summary

A breakthrough in PTSD treatment shows ketamine can provide rapid relief where traditional medications fall short. This rapid-acting antidepressant reduces symptoms within hours, compared to weeks for conventional treatments. Clinical evidence reveals ketamine and its variant esketamine offer promising pharmacotherapy options for PTSD patients who haven't responded to standard treatments, with multiple studies showing significant symptom improvement after just a few sessions.

Abstract

Posttraumatic stress disorder (PTSD) is a devastating condition, for which there are few pharmacological agents, often with a delayed onset of action and poor efficacy. Trauma-focused psychotherapies are further limited by few trained providers and low patient engagement. This frequently results in disease chronicity as well as psychiatric and medical comorbidity, with considerable negative impact on quality of life. As such, off-label interventions are commonly used for PTSD, particularly in chronic refractory cases. Ketamine, an N-methyl-D-aspartate (NDMA) receptor antagonist, has recently been indicated for major depression, exhibiting rapid and robust antidepressant effects. It also shows transdiagnostic potential for an array of psychiatric disorders. Here, we synthesize clinical evidence on ketamine in PTSD, spanning case reports, chart reviews, open-label studies, and randomized trials. Overall, there is high heterogeneity in clinical presentation and pharmacological approach, yet encouraging signals of therapeutic safety, efficacy, and durability. Avenues for future research are discussed.

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